Clinical History:

A 57-year-old white male with a 5 year history of poorly controlled systemic hypertension complained of severe deep chest pain radiating to the back in the inter-scapular region.  An abrupt decrease in carotid and upper extremity pulses was quickly followed by shock and death.  Figure 1 shows a gross photograph of his aorta at autopsy.

Questions:

1. What is your diagnosis?

2. What are the predisposing conditions? One is illustrated in Figure 2: A & C are normal, B & D are abnormal, and C & D are elastic stains.

3. What is the pathogenesis of the disease?

4. What are the most common complications?

5. What is a double barreled aorta?

ANSWERS

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